Nurses vs. Paramedics

Nurses General Nursing

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I've recently learned more about the "turf war" going on between nurses and paramedics in emergency departments for hospitals around the country. The battle seems to be heavily focused on having paramedics become licensed instead of just certified and be able to supplement ED staffs when needed and to practice their skills in the case of an off duty emergency. The paramedics I have worked with have ample skill and knowledge to handle difficult and challenging emergency situations, why then are so many nurses opposed to advancing patient care in this regard? Isn't that what our career choices are all about in the first place?

This is probably the most ill-informed post I have ever read regarding paramedics. Maybe the paramedics where you live are as unskilled as you describe (doubtful), but the ones where I live are outstanding. They have made the difference between life and death for many people, and they do their jobs under extreme circumstances.

Prove me wrong.

Here are the ALS protocols for your state. They are not much different than any other state for scope of practice. What do the Paramedics in your state do that others do not?

http://www.dsf.health.state.pa.us/health/lib/health/ems/als_protocols-effective_07-01-07.pdf

Paramedics in your state follow a very, very strict sedation intubation protocol. But, some PHRNs can do RSI.

You also need to get your head out of the clouds with the hero worship. Just like the ED, over 95% of the patients are not "life and death". And, most of the time all some provide is a really fast ambulance ride to the hospital. How many nurses also make some really good saves in the hospital? Do you say the same thing about them? What about the flight RNs? How about all the others who work outside? I bet you would walk right over the Electric lineman and never give him the time of day.

Do I think paramedics should take positions that could be filled by a nurse? No. But I can't tolerate seeing a profession that has done so much for so many being described in such a dismissive manner.

EMS has managed to dismiss their own profession for over 40 years and still can not figure out why they get very little recognition for what they do. It is time for no more shortcuts. If Paramedics want to be in a hospital, they should take the same education as the PCTs who training is directed at inhospital duties. Believe me a Paramedic would dismiss a nurse in a heartbeat in an ambulance except for ALS and CCT IFT.

I wish this wasn't so. I have advanced my own EMS education to a Bachelors level and beyond with another degree. What is frustrating is reading so many of these forums, just like on the EMS side, where some want something for nothing. Yes, my Bachelors degree does not get me any more status in the EMS world than the 3 month wonder. But EMS can not continue with the tech still few hundred hours is good enough status where you have to rely on the uniform and cool ambulance to get your respect rather than what you actually know and should be able to do.

Raise the bar for Paramedic education and then maybe we can talk about branching out into other fields.

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As with nursing education, there are various educational routes to becoming a paramedic. A major university in my region offers a 4-year bachelors degree in emergency medicine, something that might shock those of you who seem to have a vested interest in viewing paramedics as technicians with 3 months of training.

Show me where a 4 year degree is required for the Paramedic. Many schools do not require even an Associates to teach a Paramedic course.

Your comparison here is like saying all RNs have an MSN but we know that is not true especially with all the ADN vs BSNs are a waste of time threads on this forum.

Here are more University programs to compare.

University of Iowa Hospitals and Clinics Department of Emergency Medicine Residency Program

Welcome Center - School of Health Professions - The University of Texas Health Science Center at San Antonio

Yes with the one in TX you can be a Bachelors but most just take the 2 semesters.

But, several also like this one:

http://www.teex.com/teex.cfm?pageid=training&area=teex&Division=ESTI&Course=EMS135&templateid=14&navdiv=ESTI

How about this one or should I say several.

National College of Technical Instruction, EMS Courses, National Registry, Paramedic EMT Training, NCTI

It is expected students will complete most programs in approximately one year. The maximum time for completion is 18 months unless on approved Leave of Absence.

Some may like to extend their clinical time out and if you are serious, you should be done within a year.

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LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

My husband's program was 12 months full time and his paramedic program is the shortest one I know of in the area. The nearby community colleges offer programs that are longer than that (as does a certain for profit technical school that also offers MA programs), even if you're not getting getting an associate's degree in emergency services.

I've seen other posts of yours dismissing paramedics, so you clearly have a bone to pick.

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its funny, much of your post sounds just like physician's forum where they are complaining about mid-levels and nps trying to take over their "turf" or as they call it "mid-level creep."

what level of education do nps have compared with paramedics? aren't nps considered physician extenders? paramedics are not.

i've yet to see paramedics or anything trying to get paramedics to be "just like rns" i think you've read too far into the op's post. everything i've seen is allowing paramedics to do a few more advanced skills then na2s, by allowing them to do blood draws, start ivs, give o2 and monitor a pulse ox. ( advanced skills? emt-basics can do those.) all of the same things they can already do in the field. actually, it allows them to do only a few of the skills they can perform in the field, but not all. they are not replaceing rns, they area only there as an additional tech in the ed to perform some routine skills. i'd think the ed rns would like it, less routine skills for them to do, so they can focus on much more important things.

how long have you been a paramedic? ever talk with other paramedics, go to union meetings or frequent the ems forums?

i also don't get what you mean by "advanced skills" with what you have described. that is the job description of just about every er tech which can hold just an emt-b or pct or even a cna cert that gets cross trained by the hospital. the hospitals i am familiar with also make their paramedic/er techs take the 140 hour phlebotomy course and prefer they have it before being hired since there are probably over 100 applications for each er tech posting.

also, i've yet to see any paramedic program completed in 3-6 months. perhaps you've seen emt classes, which must be completed before one can take a paramedic class. please don't forget that very important pre-req. (what pre-reqs? one could only hope for a real a&p course but often that is not the case.) dot curriculum for paramedics is for 1000-1200 hours of classroom instruction. then there is usually around 150 hours of hospital clinical time, and about 250 hours of field clinical time. just 1000 hours, doing five 8 hour days would take 25 weeks to complete, just over 6 months. 3 months for a paramedic class doing 1000 hours plus all the clinical time would be impossible. i do agree they don't go to school for as long as an rn does, but they come out with a wealth of knowledge, lets not discount that.

clinicals are not that difficult to knock out since ems can do 24 hour shifts with a fire truck. if the state is only looking at clock hours and not patients or procedures, you could have these hours done in no time. many tech schools do the 3 month lecture and then allow the student to arrange their own clinicals. it is rarely structured like nursing programs.

you can also see a listing of some of the programs in my previous posts.

ems has almost 50 different certifications with each state having their own way of doing things. each state can set their own minimum amount of hours for the paramedic. even the title "paramedic" is not always used in every state. the nremt exam is not used in all states.

i've seen other posts of yours dismissing paramedics, so you clearly have a bone to pick.

i sure do. you husband only did a 12 month program. what about actually getting an associates degree? i am very sick of ems providers making excuses and not recognizing the value of education the way other professions have. i am sick of cms passing ems over because ems can not figure out what to be called or making excuses for not have an established educational standard in the u.s. in other countries your husband probably wouldn't even qualify to drive the ambulance for the paramedics and nurses who have at least a bachelors degree.

(as does a certain for profit technical school that also offers ma programs),

where do mas rate in the nursing world? i've seen several posts on this forum where rns get totally bent out of shape if an ma compares themselves to you.

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Specializes in Oncology; medical specialty website.
Prove me wrong.

Here are the ALS protocols for your state. They are not much different than any other state for scope of practice. What do the Paramedics in your state do that others do not?

http://www.dsf.health.state.pa.us/health/lib/health/ems/als_protocols-effective_07-01-07.pdf

Paramedics in your state follow a very, very strict sedation intubation protocol. But, some PHRNs can do RSI.

You also need to get your head out of the clouds with the hero worship. Just like the ED, over 95% of the patients are not "life and death". And, most of the time all some provide is a really fast ambulance ride to the hospital. How many nurses also make some really good saves in the hospital? Do you say the same thing about them? What about the flight RNs? How about all the others who work outside? I bet you would walk right over the Electric lineman and never give him the time of day.

EMS has managed to dismiss their own profession for over 40 years and still can not figure out why they get very little recognition for what they do. It is time for no more shortcuts. If Paramedics want to be in a hospital, they should take the same education as the PCTs who training is directed at inhospital duties. Believe me a Paramedic would dismiss a nurse in a heartbeat in an ambulance except for ALS and CCT IFT.

I wish this wasn't so. I have advanced my own EMS education to a Bachelors level and beyond with another degree. What is frustrating is reading so many of these forums, just like on the EMS side, where some want something for nothing. Yes, my Bachelors degree does not get me any more status in the EMS world than the 3 month wonder. But EMS can not continue with the tech still few hundred hours is good enough status where you have to rely on the uniform and cool ambulance to get your respect rather than what you actually know and should be able to do.

Raise the bar for Paramedic education and then maybe we can talk about branching out into other fields.

I worked with the medics, so I know what I'm talking about.

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Specializes in Emergency & Trauma/Adult ICU.
Show me where a 4 year degree is required for the Paramedic. Many schools do not require even an Associates to teach a Paramedic course.

I'd hate to have to quote my own post - it would seem kinda obnoxious.

I did not say that a 4-year degree was required for paramedic education. (Just as it is not required for nursing education) I offered an example of a bachelor's degree program in emergency medicine as a counterpoint to the assertion that paramedics were lesser-educated than RNs.

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I sure do. You husband only did a 12 month program. What about actually getting an Associates degree? I am very sick of EMS providers making excuses and not recognizing the value of education the way other professions have. I am sick of CMS passing EMS over because EMS can not figure out what to be called or making excuses for not have an established educational standard in the U.S. In other countries your husband probably wouldn't even qualify to drive the ambulance for the Paramedics and nurses who have at least a Bachelors degree.

Can you please quote my previous post where I said that he doesn't value continuing education or that he's making excuses? I won't go back and edit my posts while the discussion is on going.

I was responding to your assertion that medic programs are 3-6 months- there are 5 in my area that are a *minimum* of a year.

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I worked with the medics, so I know what I'm talking about.

And I am tired of people saying the education is good enough. That is insulting. Take that for what it is worth but the sooner people realize the limitations of EMS education as it is now, the sooner EMS can truly become a profession. Enough with accepting the minimum as being the end all to everything. But, then if EMS raised its standards to at least an Associates, they would be on equal status for education with the RN even if in different professions.

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Where do MAs rate in the nursing world? I've seen several posts on this forum where RNs get totally bent out of shape if an MA compares themselves to you.

I was pointing out that in my area EVEN the sketchy tech schools that churn out unlicensed medical personnel are longer than your 3-6 month figure.

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Can you please quote my previous post where I said that he doesn't value continuing education or that he's making excuses? I won't go back and edit my posts while the discussion is on going.

I was responding to your assertion that medic programs are 3-6 months- there are 5 in my area that are a *minimum* of a year.

If you husband completed a two year degree would that mean he wouldn't do any continuing education? Guess what? It is required for the cert and license.

You can stretch out "hours of training" to however long you want it to be but if it is a 1000 hour program, it is a 1000 hour program.

The LVN program is 9 - 12 months in length or about 1400 - 1800 hours. If a student decides to go part time to where it takes two years, why are they the same as an RN? Do you see a resemblance in your statement?

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Specializes in Oncology; medical specialty website.
And I am tired of people saying the education is good enough. That is insulting. Take that for what it is worth but the sooner people realize the limitations of EMS education as it is now, the sooner EMS can truly become a profession. Enough with accepting the minimum as being the end all to everything. But, then if EMS raised its standards to at least an Associates, they would be on equal status for education with the RN even if in different professions.

No one here was saying that. You were the one who jumped into the discussion and started bashing medics. Looking at your post history, you seem to have an issue with paramedics in general.

It is possible to appreciate the hard work other health care professionals provide without being derogatory toward others at the same time.

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Specializes in Emergency & Trauma/Adult ICU.
If you husband completed a two year degree would that mean he wouldn't do any continuing education? Guess what? It is required for the cert and license.

How/why are you combining initial pre-certification education and continuing education after initial certification?'

That's like trying to roll post-licensure continuing ed requirements for RNs into the diploma/ADN/BSN debate. It makes no sense.

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